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Screening Newly-Hired Health Care Employees for Latent Tuberculosis Infection

The Centers for Disease Control and Prevention (CDC) recommends all health care workers be screened for LTBI prior to new employment, regardless of risk classification. The screening can be either the tuberculin skin test (TST) or a blood test. If the TST is used, it should be the two-step method except under these conditions:

  • The newly-hired health care worker has a positive first test.
  • The newly-hired health care worker has a documented negative TST result from testing that was performed within the last 12 months.
  • The newly-hired health care worker has two or more previously documented negative TSTs-- even though the most recent was more than 12 months before new employment.
If the initial TST is positive, or the second test is positive, it is important that the individual undergo additional testing to evaluate the presence of TB disease. If TB disease is excluded, the health care worker should be treated for LTBI, unless this is not medically possible.